Home sleep apnea testing in patients with continuous flow left ventricular assist device: is it feasible?

The incidence of sleep-related breathing disorder remains unclear in patients with a continuous flow left ventricular assist device. Polysomnography (PSG) remains the gold standard for diagnosis, but logistical challenges make home sleep apnea testing a more practical alternative. WatchPat has failed to accurately diagnose sleep-related breathing disorder in this population. In contrast, the NOX-T3 utilizes more channels to monitor physiological variables, potentially offering improved diagnostic accuracy. Therefore, we aimed to validate the NOX-T3 vs PSG in detecting sleep-related breathing disorder in patients with a durable left ventricular assist device.

This is a single-center, prospective, observational pilot study. Patients with left ventricular assist device who screened positive on the STOP-BANG Sleep Apnea Questionnaire were referred to sleep clinic. Patients recommended for PSG by a sleep physician underwent PSG and NOX-T3 simultaneously. Apnea-hypopnea index with the PSG and the respiratory event index using the NOX-T3 were compared as well as time spent with oxygen saturation ≤ 88% using Spearman's correlation. P values less than .05 were considered statistically significant.

Ten patients (8 males, 2 females) were enrolled. The average age was 54 ± 15 years and 9 were implanted with a HeartMate III device. There was a strong correlation between the apnea-hypopnea index obtained from NOX-T3 and PSG (R² = .984) but the time spent with oxygen saturation ≤ 88% correlated poorly (r = .168). The tests identified the same 3 patients meeting the diagnostic criteria for obstructive sleep apnea.

Our results suggest that the NOX-T3 home sleep apnea testing device is a useful tool in the comprehensive evaluation of sleep-related breathing disorder in patients with left ventricular assist device.

Mutirangura P, Alexy T, Airhart SE, et al. Home sleep apnea testing in patients with continuous flow left ventricular assist device: is it feasible? J Clin Sleep Med. 2025;21(6):999-1005.